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Yingfeng Zheng, Ecosse Lamoureux, Wan-Ling Wong, Raghavan Lavanya, Tin Aung, Ning Cheung, Jie J. Wang, Paul Mitchell, Seang-Mei Saw, Tien Y. Wong; Prevalence and Risk Factors for Diabetic Retinopathy in an Urban Indian Population: The Singapore Indian Eye (SINDI) Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):612.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the prevalence and risk factors of diabetic retinopathy (DR) in an urban Indian population in Singapore.
A population-based study of 3,400 persons of Indian ethnicity in Singapore was conducted. Diabetes mellitus was defined as random glucose ≥11.1mmol/L, use of diabetic medication or a physician diagnosis of diabetes. Retinal photographs, taken from both eyes, were graded for the presence and severity of DR using the modified Airlie House classification system. Vision-threatening diabetic retinopathy (VTDR) was defined as severe non-proliferative DR or macular edema. Risk factors for DR were based on questionnaires, clinical assessment and laboratory tests.
Among the 3,400 study participants aged 40 and older, the age-standardized rate of diabetes was 28.4% (95% CI: 26.6, 30.3). Among the 1098 persons with diabetes and gradable photographs, the age-standardized prevalence estimate was 34.1% (95% CI: 29.8, 39.0) for any DR, 8.7% (95% CI: 6.5, 11.5) for macular edema, and 8.8% (95% CI: 6.7, 11.5) for VTDR. In multiple logistic regression, independent risk factors for any DR included longer diabetes duration (odds ratio [OR] 1.07; 95% CI: 1.06, 1.09, per year increase), higher HbA1c (OR 1.29; 95% CI: 1.12, 1.47, per % increase), history of previous stroke (OR, 2.18; 95% CI: 1.13, 4.20), and higher pulse pressure (OR 1.02, 95% CI: 1.00, 1.05, per 10mmHg increase). Older age (OR, 0.81; 95% CI: 0.67, 0.99, per decade increase) and being female (OR, 0.67, 95%CI: 0.48, 0.93) were protective against any DR. VTDR was significantly associated with longer diabetes duration (OR, 1.09; 95%CI: 1.07, 1.12, per year increase), higher HbA1c (OR, 1.25; 1.03, 1.51, per % increase), and history of previous stroke (OR, 3.49; 95%CI: 1.62, 7.49).
One third of Indian persons aged 40 years and older had diabetes. Of persons with diabetes, the prevalence of DR and its risk factors were similar to Malays in Singapore and white populations elsewhere.
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